What is female pattern hair loss?
As women age, their hair tends to thin out, although the results are not as dramatic as they are for many men - think of your grandmother's hair compared to your grandfather's (if he has any). Women's pattern of hair loss is analogous to men's, but has several important differences. The ages we begin having hair loss are the same. A few of both sexes will begin having hair loss very early--in their twenties, but most do not note changes until the mid-thirties to forties.
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Women's hair loss tends to be an even overall thinning; as opposed to men's hair loss in which the hairline recedes and/or there is balding at the crown of the head. Women tend to lose hair on the crown and at the hairline, which is referred to as female-pattern hair loss.
The most common type of hair loss seen in women is androgenetic alopecia, also known as female pattern alopecia. Alopecia means baldness, but just as in men, it does not have to be complete hair loss. This is seen as hair thinning predominantly over the top and front of the head. It affects approximately one-third of all susceptible women, but is most commonly seen after menopause
In female pattern hair loss some excess loss of hair is noted, but gradual thinning is what is what usually brings the woman to a dermatologist. Normal hair shedding is approximately 100-125 hairs per day. A lower number of hairs lost would apply to those whose hair is already thin. Hair loss occurs when the daily hair loss exceeds 100 hairs. In female pattern hair loss, when the affected hair is shed, the root grows one in its place that is shorter. Eventually it becomes invisible "peach fuzz". Genetically, hair loss can come from either parent's side of the family. Female pattern hair loss may begin as early as puberty. In these cases if there are signs of hormone imbalance, such as excess facial or body hair, a hormone evaluation should be done. Hormonal changes are a common cause of female hair loss.
Many women do not realize that hair loss can occur after pregnancy or following discontinuation of birth control pills. It may also follow any sudden physical or psychological stress to the body. These types of hair loss are "Telogen Effluvium" and are usually temporary. It is important to remember that this hair loss may be delayed by up to three months following the change. Up to 8 months will be required for regrowth to be fully achieved. A significant number of women suffer from forms of hair loss other than female pattern baldness. These other forms of hair loss must be ruled out before a definitive diagnosis of female pattern baldness can be made. Of these others, telogen effluvium is the most common. Classically, telogen effluvium is that shedding of hair that occurs several months after childbirth. Typically, the woman will notice large amounts of hair suddenly coming out one to six months after a significant stress in her life such as a surgery, a serious illness, or a social or psychological stress. The bad news is that there is no treatment for this type of hair loss. The good news is that the patient does not require any treatment. The hair should return on its own after a dormant phase. The most common type of hair loss seen in women is androgenetic alopecia, also known as female pattern alopecia. Alopecia means baldness, but just as in men, it does not have to be complete hair loss. This is seen as hair thinning predominantly over the top and front of the head. It affects approximately one-third of all susceptible women, but is most commonly seen after menopause
The most common causes of hair loss in women are not related to inherited genes, but to temporary metabolic problems associated with pregnancy, unusual stress, chemotherapy, crash diets/anorexia, thyroid hormone deficiency, major surgery, severe infection or high fever. Certain drugs can also take their toll on once lush and healthy tresses. However, these conditions are usually temporary, and once the “trauma” is alleviated, the hair shedding stops and healthy regrowth occurs with time.
The stressor causes a major change in a large portion of the hair follicles, moving them from the anagen growth phase to the catagen then telogen rest phase. The follicle then lets go of the hair that's already there while refusing to provide a replacement. Known as telogen effluvium / deffluvium, it is the second most common cause for hair loss after androgenetic alopecia. Through an unclear set of neurochemical events, the hair follicle gets the message that the body needs all the resources it has for more important things than hair, like childbirth and nursing. It usually affects small, circular patches of the scalp in no apparent pattern. The good news is, when the stress goes, the hair comes back (about 6 months later).
Although hair loss can occur with the stress of any illness, it is also a particular symptom of many different diseases. Most differ in the pattern of hair loss, and almost never resemble Male Pattern Baldness. It's also important to recognize that hair loss is seldom the first and only presentation of these diseases. Most hair comes back when the disease goes away or is adequately treated. Some of the diseases associated with hair loss are as follows: Addison's disease, Hyperthyroidism (Hashimoto's thyroditis), Hypothyroidism, Iron Deficiency, Scarring, Seborrheic Dermatitis, Secondary Syphilis , Systemic Lupus Erythematosus (SLE), and Vitiligo (there are others).
Two particularly interesting forms of hair loss are traction alopecia and trichotillomania. Traction alopecia is hair loss due to excessive and chronic pulling, or traction, on hair. It commonly occurs in people who braid or knot their hair. There is pronounced traction alopecia in the beard area of this Sikh man. In the Sikh religion, men do not cut scalp or beard hair. The beard hairs are pulled straight and then twisted and tightly knotted. Daily knotting often results in this form of traction alopecia.
In female pattern hair loss some excess loss of hair is noted, but gradual thinning is what is what usually brings the woman to a dermatologist. Normal hair shedding is approximately 100-125 hairs per day. A lower number of hairs lost would apply to those whose hair is already thin. Hair loss occurs when the daily hair loss exceeds 100 hairs. In female pattern hair loss, when the affected hair is shed, the root grows one in its place that is shorter. Eventually it becomes invisible "peach fuzz". Genetically, hair loss can come from either parent's side of the family.
Female pattern hair loss may begin as early as puberty. In these cases if there are signs of hormone imbalance, such as excess facial or body hair, a hormone evaluation should be done. Hormonal changes are a common cause of female hair loss. Many women do not realize that hair loss can occur after pregnancy or following discontinuation of birth control pills. It may also follow any sudden physical or psychological stress to the body. These types of hair loss are "Telogen Effluvium" and are usually temporary. It is important to remember that this hair loss may be delayed by up to three months following the change. Up to 8 months will be required for regrowth to be fully achieved.
Women who are seeking treatment options for androgenetic alopecia (female pattern hair loss / genetic hair loss) should stick to treatment options approved by the established medical community. At all costs, you must avoid natural hair loss treatment methods that promise miracle cures for hair loss with a shampoo or herbal pill that is "proven" to block dht or unclog pores. Treatment often starts with Rogaine (topical minoxidil 2%). Rogaine is the only FDA approved medication currently available for female pattern hair loss. The other hair loss medication, Propecia, just doesn't work in women at all. Aldactone (spironolactone) pills help many women, especially whose hair loss starts before menopause but takes many months. Hormone replacement pills, such as Prempro, plus Aldactone are better after menopause. Experienced hair transplant surgeons can often achieve excellent results in women with the new follicular unit and minigraft techniques. You have to be a qualified candidate and have realistic expectations.
If treatment fails, or is not desired professional counseling might be of help. Perms, dyes and other cosmetic options can be used to give a fuller appearance to hair. Contrary to common wisdom, shampooing doesn't increase real hair loss. Some salons specialize in the modern forms of hair additions; these have also made recent improvements in simulating a natural appearance. A consultation with a skilled specialist to discuss your options is advised.
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